Scribd
Upload
101 views1 page

Maternity Leave Application Form

The document is a Maternity Leave Application Form that collects personal details of the employee, including their name, employee number, and reporting manager. It outlines the types of maternity leave available, the start and return dates, and requires additional documentation such as a medical certificate and birth certificate. Signatures from the employee, reporting manager, and HR are also required for processing the application.

Uploaded by

Anoop K Abraham
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
101 views1 page

Maternity Leave Application Form

The document is a Maternity Leave Application Form that collects personal details of the employee, including their name, employee number, and reporting manager. It outlines the types of maternity leave available, the start and return dates, and requires additional documentation such as a medical certificate and birth certificate. Signatures from the employee, reporting manager, and HR are also required for processing the application.

Uploaded by

Anoop K Abraham
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Maternity Leave Application Form

Personal details
Employee Name:

First Middle Last

Person No: WIN ID:

Reporting
Business Unit:
Manager:

Maternity Leave Type Start Date Return Date Remarks (if any)
Leave prior to delivery (max 8 calendar
weeks)
Leave post-delivery (max 18 calendar
weeks if 8 calendar weeks leave has
been availed prior to delivery or up to
the extent of leaves applicable under the
maternity benefit act)
Other leaves (in case of leave extension
due to medical reason*)

* Please provide medical certificate.


Please provide a copy of Birth certificate of the child.

Signatures:
Employee Reporting Manager HR Use Only

Conduent Business Services India LLP Internal Use Only


Conduent Business Services India LLP HELPLINE [Link]/ethicshelpline or 000 800 9191 183
Conduent Business Services India LLP Ethics & Compliance Program Internet Site: [Link]/ethics

Page 1 of 1

You might also like